Smyth Anthony, Schwarz Ilona, Hop Jack, Leach Kelly, Frank Rachel, Bravman Jonathan, McCarty Eric
Department of Orthopedics, Division of Sports Medicine and Shoulder Surgery, University of Colorado School of Medicine, Aurora, Colorado, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Sep 12;6(6):100993. doi: 10.1016/j.asmr.2024.100993. eCollection 2024 Dec.
To identify arthroscopic rotator cuff repair study groups and evaluate if study design or other study characteristics correlate with a repeat ipsilateral shoulder surgery.
A systematic search of the PubMed, Embase, and Cochrane Library databases was conducted on March 20, 2021, and April 2, 2021. The following search terms were used by 2 different researchers: ((Rotator cuff repair[Title/Abstract]) AND (Revision[Title/Abstract]) NOT (Systematic Review[Title/Abstract]) NOT (arthroplasty[Title/Abstract]). All English-language studies published between 2002 and 2021 were manually reviewed for revision rate as a primary outcome of primary rotator cuff repair. Revision rate is defined as the percentage of primary rotator cuff repairs that underwent revision.
Sixteen studies with 25 total treatment groups were included. Five Level IV studies and 11 Level III studies encompassed a total of 95,578 patients. Of these treatment groups, the revision rate was compared by the study style (prospective vs retrospective), sample size, time required to follow up, time to follow up, average age, and postoperative American Shoulder and Elbow Surgeons score. No significant difference was found between revision rates of retrospective and prospective studies. A significant correlation was found between time required to follow up and revision rate (.42, = .0415).
In this study, we found that prospective and retrospective studies report similar revision rates after arthroscopic rotator cuff repairs. There was an association between longer follow-up and higher revision rate.
Prospective and retrospective studies yielding similar results is an important finding when showing the validity of retrospective studies. Understanding the positive correlation between a longer time for follow-up and a higher revision rate along with how age, postoperative American Shoulder and Elbow Surgeons scores, and average time to follow up correlate with revision rates is a useful consideration when designing studies and evaluating data.
确定关节镜下肩袖修复研究组，并评估研究设计或其他研究特征是否与同侧肩部再次手术相关。
于2021年3月20日和2021年4月2日对PubMed、Embase和Cochrane图书馆数据库进行系统检索。两名不同的研究人员使用了以下检索词：（（肩袖修复[标题/摘要]）且（翻修[标题/摘要]）非（系统评价[标题/摘要]）非（关节成形术[标题/摘要]））。对2002年至2021年间发表的所有英文研究进行人工审查，将翻修率作为初次肩袖修复的主要结局。翻修率定义为接受翻修的初次肩袖修复的百分比。
纳入16项研究，共25个治疗组。5项IV级研究和11项III级研究共纳入95578例患者。在这些治疗组中，通过研究类型（前瞻性与回顾性）、样本量、随访所需时间、随访时间、平均年龄和术后美国肩肘外科医师评分对翻修率进行比较。回顾性研究和前瞻性研究的翻修率之间未发现显著差异。随访所需时间与翻修率之间存在显著相关性（.42，P = .0415）。
在本研究中，我们发现前瞻性和回顾性研究报告的关节镜下肩袖修复术后翻修率相似。随访时间延长与翻修率升高之间存在关联。
前瞻性和回顾性研究得出相似结果是显示回顾性研究有效性时的一项重要发现。在设计研究和评估数据时，了解随访时间延长与翻修率升高之间的正相关关系，以及年龄、术后美国肩肘外科医师评分和平均随访时间与翻修率之间的相关性是一项有用的考量。
